LATIN Neurosurgery Journal
Document Type
Original Article
Abstract
Introduction: One of the main complications of spine tuberculosis is the instability produced by the injury of the articular structures between the vertebrae as well as the adjacent tissues, which, depending on the degree of involvement, can lead to angular kyphosis with the consequent risk of neurological impairment that can end with paraplegia. While the criteria for vertebral instability secondary to tuberculosis were identified and the pathophysiological processes that determine the progression of kyphosis following tuberculosis were deter mined, there is no new criteria, following Rajasekaran’s 2001 work, which demon strated which imaging signs could predict a kyphosis progression in children.
Study design: Systematic Review.
Objective: To determine the most im portant radiological signs that predict the progression of post-tubercular kyphosis in children.
Methods: Systematic review according to the PRISMA criteria on the most important radiological signs that predict the progression of post-vertebral tuberculosis kyphosis in children from January 2017 to July 2022. The keywords used for the search in the MEDLINE/PubMed and Scielo database were: ”(tuberculosis, spinal) and child” and their different combinations with ”(tuber culosis, spinal) and children and kyphosis” and ”(tuberculosis, spinal) and pediatric and kyphosis.
Results: Five articles were selected for f inal evaluation, of which 2 were included, which are those that fit the search criteria. Radiological signs indicating instability were dislocation of facets, posterior retropulsion of diseased fragments, lateral translation of vertebrae in anteroposterior view and collapse of the upper vertebra. Multiple regression analysis showed that a spinal instability score of more than 2 was a reliable predictor that patients would have an increase of more than 30° in deformity and with a final deformity of more than 60°.
Conclusion: Although the criteria of vertebral instability secondary to tuberculosis were identified and the pathophysiological processes that determine the progression of kyphosis after this infection were determined, no new criteria were found, after the 2001 work of Rajasekaran, a SORT 2 recommendation level was assigned.
Recommended Citation
Mier-García, Juan F.; Llanos-Lucero, Carlos A.; Aleixo-Nogueira, Pedro; Alpizar-Aguirre, Armando; Arancibia-Baspineiro, Tania; Burgos-Flores, Julio C.; Fernandes-Joaquim, Andrei; Laos-Plasier, Eduardo; Salazar-Maldonado, Byron; Salazar-Flores, Jorge; Lizarazu-Oroz, Edson; López-Segales, José L.; Magalhães-de Souza, Thiago; Molina-Pizarro, Fernando; Normabuena, Filadelfo; Núñez-Castillo, María E.; Reyes-Quezada, Erika; Quispe-Alanoca, Wilson; Sacramento-da Silva, Paulo G.; Salcedo-Moreno, Juan C.; Sánchez-Mamani, Josselin M.; Santos-de Queiroz-Chaves, Felipe A.; Simón-Nunes, Reddy A.; Soto-García, Manuel E.; Del Valle-Oros, Perla M.; Israel-Romero-Rangel, José A.; Duchén-Rodríguez, Luis M.; and Soriano-Sánchez, Jose A.
(2024)
"Imaging signs indicating post tubercular kyphosis progression in children: Systematic review,"
LATIN Neurosurgery Journal: Vol. 1:
Iss.
1, Article 7.
Available at:
https://www.latin-neurosurgery.org/home/vol1/iss1/7
References
[1] Y. W. Wong, D.Samartzis, K. M. C. Che ung, and K. Luk. Tuberculosis of the spine with severe angular kyphosis. Bone Joint J, 99-B(10), October 2017.
[2] Gururaj Sangondimath and Dr Abhinan dan Reddy Mallepally. Severe pott’s kyphosis in a 19-month-old child- case report and review of literature. World Neurosurgery, 2019.
[3] Anil K Jain, Ravi Sreenivasan, R Mukunth, and Ish Kumar Dhammi. Tubercular spondylitis in children. In dian Journal of Orthopaedics, 48(2):136, March 2014.
[4] D. Bao, L. Li, M. Gong, and Z. Xi ang. Treatment of atlantoaxial tubercu losis with neurological impairment: A systematic review. World Neurosurgery, 2019.
[5] S. Rajasekaran. Mechanical stability of the thoracic spine in tuberculosis. Jour nal of Bone and Joint Surgery [Br], 83 B:954–962, 2001.
[6] Myung-Sang Moon, Sang-Jae Kim, Min Su Kim, and Dong-Suk Kim. Most re liable time in predicting residual kypho sis and stability: Pediatric spinal tubercu losis. Asian Spine Journal, 12(6):1069 1077, 2018.
[7] S Rajasekaran, Dilip Chand Raja Soundararajan, Ajoy Prasad Shetty, and Rishi Mugesh Kanna. Spinal tubercu losis: current concepts. Global Spine Journal, 8(4 suppl):96S–108S, 2018.
[8] Anil K Jain, Ravi Sreenivasan, R Mukunth, and Ish Kumar Dhammi. Tubercular spondylitis in children. In dian Journal of Orthopaedics, 48(2), March 2014.
[9] Kaustubh Ahuja, Syed Ifthekar, Samarth Mittal, Gagandeep Yadav, Bhaskar Sarkar, and Pankaj Kandwal. Defining mechanical instability in tuberculosis of the spine: a systematic review. EFORT Open Reviews, 6, March 2021.
Included in
Epidemiology Commons, Health Information Technology Commons, Neurosciences Commons, Neurosurgery Commons